Super gonorrhea has infected humans in the United States for the first known time. This Monday, Massachusetts public health officials announced the finding of two gonorrhea cases appearing to display enhanced resistance to all known antibiotic classes that can be used against it. These instances were thankfully still treatable, but it’s the latest reminder that this prevalent sexually transmitted infection is becoming a more serious menace.
Gonorrhea, caused by the eponymous bacteria Neisseria gonorrhoeae, is the second most often reported STI in the U.S., with 677,769 cases documented in 2020. Many infected people don’t develop disease, although initial signs might include a colorful discharge from the genitals, painful or burning urine, and rectal bleeding if caught during anal sex. When gonorrhea is left untreated, it enhances the chance of more serious problems, like damage to the reproductive system in women and enlarged testicles in males, both of which can lead to infertility. And when it’s handed down from mother to kid, the illness can be deadly or cause blindness in babies.
While gonorrhea was formerly easily curable with a simple pill of penicillin or other antibiotics, the bacteria has steadily learned to withstand practically every treatment put in its path. These days, only one or two antibiotics given simultaneously (depending on the region) are deemed reliably effective against gonorrhea and are recommended as front-line therapies. But in recent years, doctors have encountered gonorrhea, which has started to elude even these treatments. These extensively hardy or pan-resistant illnesses have been described in regions of Europe and Asia to date, but at least two identical cases have now been detected in Massachusetts.
According to the state health department, the strain of gonorrhea separated from one instance demonstrated resistance or diminished response to five types of antibiotics. The strain retrieved from the second case was genetically related enough that it would likely have comparable resistance. A common genetic signature detected in these cases was previously identified in a case reported in Nevada, although that strain still responded generally to at least one class of antibiotics. As far as health experts know, these are the first reported gonorrhoea cases to exhibit enhanced resistance to all of the drug classes known to treat it ever identified in the U.S.
“The discovery of this strain of gonorrhea is a serious public health concern which DPH, the CDC, and other health departments have been vigilant about detecting in the US,” said Public Health Commissioner Margret Cooke, in a statement from the agency
The United States will no longer prescribe azithromycin as a treatment for gonorrhoea if resistance rates to the antibiotic continue to rise, which is expected to occur around the year 2020. Currently, the sole treatment that is regarded as a first-line option in the country is the antibiotic ceftriaxone, administered in a larger dose than it was in the past. Fortunately, both cases were successfully resolved when patients received these larger dosages of ceftriaxone, despite the fact that the lower response to ceftriaxone.
These incidents are most likely only a foreshadowing of things to come. It has been discovered that pan-resistant instances have occurred in both Europe and Asia, which is evidence that these mutations are continuing to spread throughout the globe. Some of the significant genetic markers found in this unique strain were in these pan-resistant cases. In the United States, gonorrhoea infection rates have been on the rise from one year to the next. In addition, there is no evidence of a direct link between the two instances in Massachusetts, which suggests that these strains may already be spreading beyond the point where they can be easily confined. This is undoubtedly the most worrisome finding.
There are continuing efforts to create vaccines and new medications that are effective against gonorrhea; however, it could be years before any of these come to fruition if any of them do at all. Therefore, it is more essential than ever before to practice safe sexual behavior in order to avoid acquiring and spreading sexually transmitted infections (STIs). Officials in charge of public health are now notifying medical professionals and testing facilities in Massachusetts to be on the lookout for and report any comparable instances.
We strongly encourage all sexually active persons to get tested for sexually transmitted illnesses regularly, to consider cutting down on the number of sexual partners they have and to wear condoms more frequently when they are engaging in sexual activity. “I would want to ask clinicians for their assistance in reviewing the clinical alert and contributing to our enhanced surveillance efforts,” Cooke added.
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